This presentation was delivered at the inaugural conference of the International Society for Digital Medicine in Nanjing on June 19th. The presentation features digital health and gamification applications from GAETSS partners including Milan Based Imaginary and UK personal health management specialists, Spirit Healthcare. ABSTRACT Modern Lifestyles represent one of the biggest health challenges to modern society. The combination of higher standards of living, extended life expectancies and falling birth rates has led to a cocktail of medical problems that affect, in different ways, all age groups whether it be childhood obesity, diabetes and cardiovascular problems in adults or physical and cognitive decline in the elderly. These challenges, and the decline in the relative percentage of people in employment means that the public and private health services are facing a demographic time-bomb which, without intervention and effective strategies is likely to cause serious social and economic disruption. This presentation examines the potential of wearable devices, gamification, artificial intelligence and big data used in digital health and wellbeing applications to have a positive impact on public health as well as facilitating new relationships between citizens and healthcare providers for personal health management and improved lifestyle behaviours.

1. Digital Health and Gamification
How Technology and Gamification can support Physical and
Mental Well-Being in the Ageing Society
Nanjing
June 2016

2. Topics
 Background and Introduction – the Ageing Society
 The Challenge of Lifestyle Related Conditions
 Gamification theory and practice
 Digital Health and Gamification in Practice
 Practical Case Studies
 Project Results
 Conclusions
 Acknowledgements

3. The Ageing Society

4. The Ageing Society and Health

5. The Message
Lifestyle Related Conditions are the most important
cause of premature death and actions which
influence healthy lifestyles should be adopted as
early as possible in your life

6. The Transition from Cure to Prevention
It’s quite clear that the best chance we have for
increasing our life spans and overall improving
our health is to adjust our personal behaviours
and to do so at an early age.
6

7. The Challenge of Lifestyle Related Conditions
One of the consequences of a
convenient and easy access to
our daily wants and needs is a
decline in the physical and
mental challenges necessary
for our lifelong development
and health maintenance.
It is difficult to influence lifestyle behaviours when the
consequences of poor lifestyle choices are not immediately
reflected in your perceived health condition

8. What can be Done ?
The consequences of a failure to address these challenges are unthinkable…..

9. Gamification and Digital Health
Leveraging Disruptive Technology to Address Global Challenges

10. Digital Health
Internet of Things & Sensors
Biosensor technologies, Cloud computing, big data analytics,
data visualisation and mobile apps will transform personal health management

11. Gamification Theory and Practice
 The application of game psychologies
and mechanics within non-game
sectors
 Engagement, motivation, skill
development, understanding,
influencing behaviour
 Measurement and feedback
 Competition, team working, social
connections and Community building
 Self-efficacy is critical to health
behaviours
 User-centred design

12. Digital Health and Gamification in Practice
 Wearable technologies personal case study
 CliniTouch System for Chronic Conditions
 Buddy Band and SPORTIVATE Walk around the World
 Rehab@Home for rehabilitation and patient monitoring
 DOREMI for developing healthy active ageing
 PEGASO influencing healthy lifestyles in teenagers

13. Personal Case Study

14. An Approach for Better Personal Health
Gamification Digital Health Technologies

15. SPORTIVATE
Walk Around the World

16. Clinitouch
Management of Chronic Conditions from Home
Significant reduction in hospital admissions for COPD Trial
The number of admissions decreased from 3.13 to 1.02 admissions per patient over the 12-month period (p < 0.001).
The overall net saving to the LC CCG over the 12-month period was £117 550.

17. Rehab@Home Project
 Rehabilitation exercises after stroke or
physical injury
 Uses Microsoft Kinect to provide customised
exercises
 Feedback to both patient and medical
practitioner
 Avoids travel and expensive use of facilities
 Personalised exercise routines
 Win-win scenario

18. DOREMI Project
 Promotes physical and cognitive wellbeing
and independence
 Focus on physical activity, good diet, social
support and mental stimulation
 Range of applications on tablet computers
with mental and physical exercise
 Provides valuable feedback data to clinicians
and carers
 Gamification provides both mental
stimulation and motivation for physical
activity
http://www.doremi-fp7.eu/

19. Pegaso Project
 Targets obesity in young people
 Encourages healthy eating and exercise
 Uses a pervasive game developed by
Imaginary
 Combines wearable sensors, food diaries,
companion messaging and gamification
strategies
 Game mechanics co-designed with teenage
focus groups – “Zombies Attack Game”
 Short-term intervention leading to long-term
lifestyle changes
http://www.pegasof4f.eu/

20. Project Results
 CliniTouch
– The number of admissions decreased from 3.13 to 1.02 admissions per patient over the
12-month period (p < 0.001). The overall net saving to the LC CCG over the 12-month
period was £117 550.
– Patient feedback suggested patients were more knowledgeable about their condition,
more confident in managing it and motivated to change behaviour in a positive direction
as a result of being involved in the intervention.
 Rehab@Home
– 15 patients ( 5 post-stroke and 10 multiple sclerosis)
– Improvements in exercise tolerance and fine use of hand
– Positive feedback from participants
 Pegaso
– 28 Adolescents (10 Italian and 18 Spanish)
– Preference for reward system for good behaviour
– Differences in cultural preferences for game mechanics
 DOREMI
– 8 Focus groups (4 in Italy, 4 in UK)
– Normal or mild cognitive impairment, 4-8 people per group, aged 65-80
– Iterative user-centred design proved most effective
– Important to consider age-related visual decline and manual dexterity
– 3 key principles (meaning to participants, mastery for game flow and autonomy)

21. Conclusions
 Common themes of Gamification and Consumer Digital Health Technologies
 Reduction in hospitalisation and clinician workload
 Potential to protect healthcare provision for future generations
 Use of Key Digital Health Performance Indicators and Game Psychology
 Pegaso emphasises exercise and eating behaviour in adolescents critical for
avoiding health challenges in later life
 Rehab@Home illustrates the potential of consumer games technologies for
patient and clinician empowerment and collaboration
 DOREMI shows that older people will accept appropriate games that can
reduce the burden of cognitive and physical decline
 Medical professionals should play a key role in emerging health ecosystems that
build win-win relationships with all sectors of society to prevent the potential
melt-down of public health services arising from lifestyle related medical
challenges

22. Acknowledgements
This work has been supported by the European Commission under the collaborative projects
Rehab@Home, DOREMI and PEGASO all funded by the European Commission under the
Seventh Framework Programme

23. Contacts
imaginary_italy
www.i-maginary.it
imaginarysrl
Piazza Caiazzo,3
20124 Milano
PH. +39 02 89458.576
FAX +39 02 89458.695 david.wortley@i-maginary.it

24. Example Videos on Youtube

25. RehAbility

26. Pegaso

27. DOREMI

28. Smart Hospital

29. Gear-Up Game